International Student Enrolment Form

International Student Enrolment Form It is important that you read the information, terms and conditions in the Enrolment Form, Student and Enrolment ...
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International Student Enrolment Form It is important that you read the information, terms and conditions in the Enrolment Form, Student and Enrolment Agreements before signing. This enrolment form and additional documents can be scanned and sent to Lincoln High School by email or fax. Alternatively, the original application, along with the copies of your documents (reports, letters, passport and photograph), can be posted to: Lincoln High School International Office 25 Boundary Road Lincoln 7640 NEW ZEALAND

Telephone Fax Email: Website:

+ 64 3 325 2121 + 64 3 332 2509 [email protected] www.lincolninternational.school.nz

IMPORTANT: 

When you have completed the form, please use the checklist below to make sure you have sent all the documents and information we need Please print clearly in English using CAPITAL LETTERS



Please attach a passport-size photograph of the student here

Student’s Details (please print clearly in English using CAPITAL LETTERS) Family name/Last name (as shown in passport):

Given name(s)/First name(s) (as shown in passport):

Preferred First name

Gender (Tick one)  Male  Female

Date of Birth

DD MM YYYY

Checklist - Documents and Information you must attach with your application     

One passport sized photograph School Reports (in English) from schools attended in the previous 12 months A letter of recommendation from the Principal or English teacher of the most recent school attended A personal letter stating the reasons for applying to study at Lincoln High School A copy of your Passport including Passport number and expiry date

Lincoln High School

International Enrolment Form

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Passport Details Student’s Passport Number

Country issued

Passport expiry date

DD

MM

Nationality

Date of NZ arrival

YYYY

DD

MM

YYYY

Parent’s details Father’s last name

Father’s first name

Mother’s last name

Mother’s first name

Speaks English:  Yes  No Speaks English:  Yes  No

Address

City

Country

Father’s Occupation:

Mother’s Occupation:

Email address (please print clearly)

Phone number (Country code + Area code + Number)

Cell phone (Country code + Area code + Number)

Fax number (Country code + Area code + Number)

If parents are separated, who do you live with?

Mother



Father



Emergency contact (if we cannot contact your parents) Last name

First name

Speaks English:  Yes  No

Relationship to student

Phone number (Country code + Area code + Number)

Email address (please print clearly)

Cell phone (Country code + Area code + Number)

Agent Details (complete only if you have one) Agency name

Contact person

Full Postal Address (address + suburb + city + postal code + country)

City

Country

Email address (please print clearly)

Website

Phone number (Country code + Area code + Number

Fax number (Country code + Area code + Number)

Cell phone (Country code + Area code + Number)

Lincoln High School

International Enrolment Form

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Support person/Guardian/Relative in New Zealand (complete only if you have one) Company name

Contact person

Full Postal Address (address + suburb + city + postal code + country)

Email address (please print clearly)

Phone number (Country code + Area code + Number)

Fax number (Country code + Area code + Number)

Cell phone (Country code + Area code + Number)

Course and School Details Level of study requested Start date:  Year 9  Year 10  Year 11  Year 12  Year 13  Term 1  Term 2  Term 3  Term 4 Length of course  Academic year  Three terms  Two terms  One term  Other (please state): Have you studied at a NZ school before?  Yes  No (If yes, please state name of the school)

Year: 20____

I wish to take the following subjects: (List in order of preference)

1. 2. 3.

4. 5. 6.

How many years have you studied English?

What is your level of English?

Please note: The course of study is dependent upon English and academic ability. In some cases it is not always possible to gain entry to your first choices of subjects as classes may be full – particularly if you arrive mid – year. However, we will ensure you have a course which is suitable to you and your level of achievement. The school reserves the right to determine the appropriate level of study or recommend a transfer for further study in the English Language.

Your School History Overseas Year

Name of school

Country

Year

Name of school

Country

Sporting & Cultural Sport

Number of years played

Sport

Number of years played

Musical instrument you play

Number of years played

Language

Number of years studied

Other

Number of years studied/played

Level:  beginner Level:  beginner Level:  beginner Level:  beginner Level:  beginner

 elementary  intermediate  elementary  intermediate  elementary  intermediate  elementary  intermediate  elementary  intermediate

Medical details (to be completed by a parent) Lincoln High School

International Enrolment Form

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Please tick the box of any medical conditions your child suffers from:

 Allergies

 Asthma

 Back/Neck problems

 Bee sting

 Diabetes

 Epilepsy

 Food Allergies

 Glandular fever

 Heart conditions

 Hepatitis A or B

 Migraines

 Rheumatic fever

 Other

Does your child wear glasses?

 Yes

 No

(If yes it is advisable to bring your glass prescription in case of breakage)

Does your child have hearing difficulties?

 Yes

 No

Medical details (to be completed by a parent) Please write details of any condition you have:

Is your child taking any medication?  Yes  No (If yes, please list and explain)

Are there any other physical or mental health conditions or concerns that would place your child at risk? (e.g. depression)  Yes  No (If yes, please explain)

Does your child have any learning or behavioural needs? (e.g. dyslexia)  Yes  No (If yes, please explain)

Please note: If your child is on any medication, it is advisable for them to bring it to NZ Insurance

 It is compulsory for International Students to have medical insurance while in New Zealand Lincoln High School is able to purchase Unicare insurance. This policy is compliant with the NZ Code of Practice for International Students. The brochures are available at www.uni-care.org.nz Please tick one: o I would like Lincoln High School to arrange Insurance and add it to my invoice o I will take out medical and travel insurance and will send Lincoln High School a copy of the policy in English before I leave my home Country and understand that the insurance must meet the requirements for International Students under the Code of Practice for the Pastoral Care of International Students (2010)

Accommodation details Please tick one: Lincoln High School

International Enrolment Form

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o o o o

I would like Lincoln High School to arrange a homestay for me and to add it to my invoice I will be living with a family friend or family member (Designated Caregiver) I will be living with one of my parents. If yes which NZ Visa will your parent have Visitor Visa Is either parent intending to apply for a Work Permit, Business Visa or Permanent Residency?

 Yes  No  Yes  No  Guardian Visa   Yes  No



A designated caregiver must be either a close friend of your parents, or a family member. This accommodation must be approved

by the school before you arrive and adults over the age of 18 living in the house will be police checked (the school arranges this when they visit)

Name of Designated Caregiver:

Relationship to you:

Address: Email address:(please print clearly)

Phone number: (Country code + Area code + Number)

Cell phone: (Country code + Area code + Number)

Accommodation Requests Please answer the questions below:

o o o o o o o o

Would you feel comfortable living with small children?  Would you feel comfortable living with another international student of a different culture?  Would you feel comfortable living with a family with no children?  Would you prefer to live in a family with children of the same age?  Would you feel comfortable living with a family where one parent smokes?  Would you attend church with your host family?  Do you have a religious affiliation?  If YES please state: _______________________________________________________________ Many New Zealand families have pets. Are there any concerns regarding pets?  If YES, please explain: _______________________________________________________________

Yes Yes Yes Yes Yes Yes Yes

      

No No No No No No No

Yes  No

_________________________________________________________________________________

o What time do your parents expect you home in the evenings? Week days ___________ Weekends ___________ o

 Yes  No

Are you a vegetarian or have diet restrictions due to your religion? If YES, please explain: _______________________________________________________________ _________________________________________________________________________________

o Do you have any food allergies?

 Yes  No

If YES, please explain:________________________________________________________________ __________________________________________________________________________________

Lincoln High School

International Enrolment Form

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Letter to Prospective Host Family PLEASE NOTE: Only students who will be staying with a Lincoln High School host family should write this. Please use this page to write a ‘Dear Family’ letter. Please tell them about your family, hobbies, friends, home and school life. You might like to write about why you want to come to New Zealand. You can use extra paper if you wish.

PHOTOS: Please attach any photos of yourself with your family

Refund Procedure Lincoln High School

International Enrolment Form

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In accordance with the Education Amendment Act (No 4) 1991, an International Student enrolled for a course of study at Lincoln High School and wishing to withdraw, is entitled to: 1. Withdraw before 7 days of course commencement a) Full payment of tuition fees minus NZ$100 enrolment fee 2. Withdraw within 7 days of course commencement a) Refund of remaining fees minus administration fee of $500. 3. Withdraw any time after 7 days of course commencement a) Refunds of tuition fees made in exceptional circumstances b) A refund of remaining fees minus an administration fee of $500 and any other costs incurred on behalf of the student e.g. agent’s commission, government levy. c) All unused homestay fees and contingency fees will be refunded without permission from the Board of Trustees 4. No refund when enrolment is withdrawn by the school 5. No refund when passport status has been changed to permanent residence 6. No refund if a student chooses to change schools after 7 days of course commencement In order to be eligible for any refunds, the student must apply in writing to the Chairman of the Board of Trustees, stating the reasons for withdrawal from the course of study.

Grievance Procedures Lincoln High School has established guidelines for students who have a complaint or grievance against the school. The procedure for dealing with such an issue is: 1. International students who consider that they have a concern, complaint or grievance with Lincoln High School should in the first instance discuss the concern with the Director of International Students. 2. If the matter is not resolved to the satisfaction of the student, the student or their authorized agent/representative should then take up the matter with the Principal. 3. If the matter is still not resolved satisfactorily, the student should put their concern in writing to the Board of Trustees of Lincoln High School. The board will then consider the matter and come to a decision. 4. If, at this stage, the student is still not satisfied with the outcome, the complaint should be taken to the International Education Appeal Authority (IEAA). The IEAA will receive and adjudicate on complaints received from International Students or their authorized agents/representatives concerning breaches of the Code of Practice for the Pastoral Care of International Students (2010). Information about the IEAA is available in the International office, or by mail at: The International Education Appeal Authority Tribunals Unit Private Bag 32-001 Panama Street Wellington 6146 New Zealand

Lincoln High School

International Enrolment Form

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Medical Release Authorisation We give Lincoln High School, its employees, and the host family, at their discretion, and, if necessary, at the cost of the student or his/her natural parents – in the case of expenses exceeding the coverage of the insurance cover, the power to place the student in a hospital; or in any other institution for any type of assistance or medical treatment, or, if there is no hospital available, to place him/her under the case of a local medical doctor for his/her treatment. We also grant Lincoln High School all necessary permissions to act as legal guardians and “in loco parentis” in any situation, especially in emergencies, whatever medical or other, including the possibility for surgical operations or any other treatment. We also authorise Lincoln High School to return the student to their home country at his/her cost, if necessary, to submit to medical treatment, if this is deemed necessary by the above-mentioned people, after consultation with medical authorities. We confirm that at the time of signing this document, our child enjoys perfect health, and that his/her health record as filled in by a parent on the application form is true and complete. We also grant Lincoln High School the power to act on our behalf in anything pertaining to possible representation before local authorities. This authorisation shall be valid for the entire duration of the student’s study programme at Lincoln High School.

Parent Signature: _________________________________________________ Date: ___________________________

Travel Authorisation Form In the interests of safety, it is necessary for all holiday travel plans to be approved by the International Director before any bookings or arrangements are made. In general, approval will NOT be given for independent travel or for travel to be undertaken without adult supervision. In addition, an email from the student’s natural parent (s) must accompany this form. The email must clearly state the parents’ agreement and permission for the student to undertake organised and supervised holiday travel, and the parents’ acceptance of full responsibility for the travel. The parents’ email must clearly state that the parents accept that Lincoln High School is not organising or supervising the independent travel. We, the parents of the student, hereby authorise Lincoln High School, as agents of the natural parents, to make the determination for student travel for the length of the student’s enrolment at Lincoln High School. This authorisation is given in advance only when the student is travelling and supervised by a host parent or by a representative of the school .

Parent Signature: __________________________________________________ Date: __________________________

Photographs and Marketing Material

Lincoln High School

International Enrolment Form

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As a parent, I grant permission for the school to take photographs of my child during school activities and that the school may use those photographs on the Lincoln High School website, international newsletters and school newsletters, as well as in marketing material for the school. Parent Signature: __________________________________________________ date: _____________________________

Liability Release The undersigned, as student and parents, on behalf of ourselves, and our legal representatives, renounce to claim against Lincoln High School, teachers, co-ordinators, any person intervening on behalf of the school, that may arise due to injury, damage, sickness, accident, delay, unusual circumstances or expenses due to strikes, war atmospheric conditions, quarantine, government restrictions of regulations, or those derived from acts of omission of airlines, shipping companies, railroads, buses, transportation in general, hotels, restaurants or any other service given by companies, individuals or anyone related with the aforementioned. We understand that the student will be subject to the authorities and teachers of the school and that he/she will have to follow the rules given by the family. We also understand that Lincoln High School reserves the right to terminate the programme of any participant whose conduct may be considered detrimental or incompatible with the interest and security of the school or the student. The student agrees to accept and uphold the standards of conduct (behaviour) set by Lincoln High School and the host family for the duration of the programme. He/she also agrees to maintain friendly and respectful relations with his/her teachers and the classmates and, especially, with all the members of the family, to accept the rules of conduct and to participate in family life as much as possible. Parent Signature: _________________________________________________ date: ______________________________ Student Signature: ________________________________________________ date: ______________________________

I have read and understood ALL the information in this booklet regarding Lincoln High School Fees Refund Policy, Code of Practice and Grievance Policy. I declare that the information supplied is true and correct. Parent Signature: ____________________________________________ date: ___________________________



Failure to disclose all or give false information may lead to termination of your application

Lincoln High School has agreed to observe and be bound by the Code of Practice for the Pastoral Care of International Students (2010) published by the New Zealand Qualifications Authority (NZQA). Copies are available on request from this institution or from the NZQA website at www.nzqa.govt.nz

Lincoln High School

International Enrolment Form

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